Rosemarie B. Greco, who has spearheaded Gov. Rendell's health-care initiatives from easing doctors' soaring medical-malpractice premiums to expanding coverage to the uninsured, will leave the administration at the end of the year.

Her six-year tenure was a busy and contentious period for health-care policy that is likely to continue.

Rendell's first act after being sworn in as governor in 2003 was to establish the Office of Health Care Reform and appoint Greco as its director.

From there, the former bank executive, now 62, served as the point person for Rendell's proposal to transform the state's health-care system. The governor's Prescription for Pennsylvania, a key effort of his second term, was meant to improve medical quality and broaden health-insurance coverage.

The governor's team scored some successes on initiatives to reduce hospital-acquired infections and promote better chronic care. But the effort to get coverage for the state's 800,000 uninsured adults failed to gain traction in the legislature.

"I know Rosemarie's one regret about her time in Harrisburg was our inability to achieve health-care coverage for the uninsured," Rendell said in a statement. "We haven't given up on that."

In an interview, Greco, of East Falls, who was paid $48,000 in the position, said she planned to initially spend three years in the job and ended up staying for six.

She called her tenure "bittersweet for lots of reasons": sweet because of what was accomplished, she said, and bitter because there remains much to do.

"I lost my innocence," said Greco, who will be succeeded by her deputy, Ann Torregrossa.

Greco said she would continue to serve as a senior adviser to Rendell for health care, and would help represent the governor in the national health-care debate soon to accelerate in Washington. She will also focus on the various boards she serves on, including Sunoco, Exelon, SEI, the Pennsylvania Real Estate Investment Trust, and the University of Pennsylvania School of Nursing.

Before joining the Rendell administration, Greco founded and ran a business-consulting firm, Greco Ventures Ltd. She left a mark on Philadelphia business, serving as president and chief executive officer of CoreStates Bank and being at the time the highest-ranked women at any U.S. bank.

"She approached her job as she would have in the private sector," Rendell said in the statement. "She respected people and their differing opinions. She blended those differences into solutions that the interested parties could accept and that would ultimately help people."

Daniel Glunk, president of the Pennsylvania Medical Society, which has been sharply critical of the administration at times, said the society had "a good relationship" with Greco: "Rosemarie is a person of integrity. She put an enormous amount of effort into a newly created role. She's worked hard to improve health care for all citizens."

Although the legislature did not pass measures to expand coverage to the uninsured, Glunk praised Greco for working tirelessly to get that accomplished.

He credits her with "bringing all the different parties in the health-care-delivery system together to attempt to find solutions to many problems. She certainly is inclusive, and she respects others' points of view."

The battle with the Republican-controlled state Senate over the uninsured will soon fall to her successor, Torregrossa.

On Dec. 31, Rendell will appoint Torregrossa, an experienced health-care lawyer who headed the Pennsylvania Health Law Project, as director of his Office of Health Care Reform, overseeing its $1.2 million budget.

Since 2003, Torregrossa has served as deputy director. She was instrumental along with Greco in developing Rendell's health-care proposals.

Rendell said Torregrossa "is passionate about these issues and I look forward to working with her . . . to make the rest of our agenda a reality."